• J Neurointerv Surg · Apr 2019

    Multicenter Study

    Treatment strategies for recurrent and residual aneurysms after Woven Endobridge implantation.

    • Christoph Kabbasch, Lukas Goertz, Eberhard Siebert, Moriz Herzberg, Christina Hamisch, Anastasios Mpotsaris, Franziska Dorn, and Thomas Liebig.
    • Department of Neuroradiology, University Hospital of Cologne, Cologne, Germany.
    • J Neurointerv Surg. 2019 Apr 1; 11 (4): 390-395.

    BackgroundWoven Endobridge (WEB) embolization is a safe and efficient technique for endovascular treatment of intracranial aneurysms. However, the management of aneurysm recurrence after WEB placement has not been well described to date. We present our multicenter experience of endovascular retreatment of aneurysm recurrence after WEB implantation.MethodsThis is a multicenter study of patients who underwent endovascular retreatment after WEB implantation in three German tertiary care centers. Treatment strategies, complications, and angiographic outcome were retrospectively assessed.ResultsAmong 122 aneurysms treated with the WEB device, 15 were retreated. Of these, six were initially treated with the WEB only, two were pretreated by coiling, and seven large aneurysms were treated in a multimodality approach. Ten were true aneurysm remnants and five were neck remnants. The reasons for retreatment were WEB migration (n=6), initial incomplete occlusion (n=5), and WEB compression (n=4). Retreatment strategies included coiling (n=4), stent-assisted coiling (n=7), flow diversion (n=3), and placement of an additional WEB (n=1). All procedures were technically successful and there were no procedure-related complications. Among 11 patients available for follow-up after retreatment, three were retreated again. At last angiographic follow-up, available in 11/15 cases at a median of 23 months, complete occlusion was obtained in eight cases and neck remnants in three.ConclusionsThis pilot study shows that endovascular retreatment of recurrent or residual aneurysms after WEB implantation can be done safely and can achieve adequate occlusion rates.© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

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